NPIMap

Organization Active NPI

Mawn Chiropractic PA

Doing business as The Source Chiropractic

  • Chiropractor
  • St Petersburg, FL
National Provider Identifier
1306418678
Registry record updated Nov 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
Legal business name
MAWN CHIROPRACTIC PA
Doing business as
The Source Chiropractic
Practice address
2500 1St Ave N
St Petersburg, FL 33713-8702
Phone
(727) 329-6106
NPI assigned
Jul 15, 2021
Last updated
Nov 6, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 6, 2023

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Dyllon Mawn, D.C.NPI 1053066910
Title
Owner/President
Phone
(561) 876-2157

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X Primary

Addresses

Primary practice location

2500 1St Ave N
St Petersburg, FL 33713-8702

Mailing address

5751 11TH St S
St Petersburg, FL 33705-5021

Other practice location 1

424 Skinner Blvd Apt D
Dunedin, FL 34698-4995
Phone (727) 330-6718

Other names 1

  • The Source Chiropractic Doing business as

National Provider Directory

National Provider Directory

Locations

424 Skinner Blvd
Apt D
Dunedin, FL 34698
Phone (727) 330-6718

2500 1st Ave N
St Petersburg, FL 33713
Phone (727) 329-6106

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1626307200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1699228800000",
    "number": "1306418678",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5751 11TH ST S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337055021"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 1ST AVE N",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337138702",
            "telephone_number": "727-329-6106"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "424 Skinner Blvd Apt D",
            "address_purpose": "LOCATION",
            "city": "Dunedin",
            "state": "FL",
            "postal_code": "346984995",
            "country_code": "US",
            "telephone_number": "727-330-6718",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MAWN CHIROPRACTIC PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-07-15",
        "last_updated": "2023-11-06",
        "certification_date": "2023-11-06",
        "status": "A",
        "authorized_official_last_name": "MAWN",
        "authorized_official_first_name": "DYLLON",
        "authorized_official_title_or_position": "OWNER/PRESIDENT",
        "authorized_official_telephone_number": "561-876-2157",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "D.C."
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Source Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "The Source Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.